Provider Demographics
NPI:1114339611
Name:NEWCOMBE, JODI A (MD)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:A
Last Name:NEWCOMBE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6729
Mailing Address - Country:US
Mailing Address - Phone:207-535-1200
Mailing Address - Fax:207-535-1249
Practice Address - Street 1:385 ROUTE 1
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6729
Practice Address - Country:US
Practice Address - Phone:207-535-1200
Practice Address - Fax:207-535-1249
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD22719207Q00000X
VA0101263608208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice